Any IB Psychology taking the Abnormal option knows about placebos, do you also know about nocebos?

Placebos are weird​ (do you know that branded placebos work better than unbranded ones?), nocebos are weirder. Take for example the man who was on a clinical trial for a depression medication. He presented to Accident and Emergency one night after swallowing a whole bottle of the meds he had been prescribed exhibiting all of the signs and symptoms of an overdose of antidepressants. It was serious, he was hyperventilating, his blood pressure plummeted and he collapsed at reception. No trace of the drug could be found in his system and it was only hours later that another doctor arrived and was able to inform everyone that the man was overdosing on sugar pills - he had been assigned to the placebo condition on the clinical trial. His recovery was swift! Welcome to the strange world of the nocebo.

A nocebo (Latin for "I will harm") is something that should be ineffective but which causes symptoms of ill health. A nocebo effect is an ill effect caused by the suggestion or belief that something is harmful. Examples include:

More than two thirds of college students who were told that a nonexistent electrical current passing between two electrodes on their head would cause headaches, subsequently reported a headache.

Japanese researchers tested boys who reported being allergic to a particular plant. One arm of each boy was brushed with the allergenic plant and boys were informed that it was an innocuous plant. Simultaneously, the other arm wa brushed with an innocuous plant and the boys were informed that it was the allergenic plant. Within minutes, the arms brushed with the innocuous plant (which the boys believed they were allergic to) developed rashes and blisters,

In one of the largest and most prestigious longitudinal studies, women who believed that they were at risk of developing heart trouble were up to four times as likely to die of a heart attack then women with matched risk factors, but who didn't believe they were at risk.

Could it also account for those individuals who believe they are wifi sensitive or report that wind turbines, that nobody hear, are causing health problems?; i.e., if you think you are being negatively by something, then your brain makes sure that you are!

Remember, we take the hard work out of IB Psychology - with complete sets of model examination answers!

"Okay Mr Burton, all very interesting I guess, but how do we use it in our IB Psychology exams?", I hear you ask. Well, apart from the fact that that it makes a fascinating topic to explore in the IB Psychology extended essay, it also fits in very well with the IB Psychology Abnormal option in at least three learning outcomes:

Describe symptoms and prevalence of one disorder

Analyse etiologies of one disorder

Examine biomedical, individual and group approaches to treatment.

It could also wow your IB Psychology examiner in your IB Psychology Paper 1 examination - when you are answering the Biological Level of Analysis (BLOA) ERQ: "Using one or more examples, explain effects of neurotransmission on human behaviour." Here, when you discuss the placebo effect in relation to the neurotransmitter serotonin, why not amaze you marker with your knowledge of how the mysterious human brain works and use the nocebo effect as additional support for your argument (just keep it short!).

We could imagine it going something like this: "... Just as the placebo effect is said to account for much of the efficacy of serotonin reuptake inhibitors in many patients, so too could the nocebo effect cause the drug not to work in certain individuals. For example, if a patient prescribed an antidepressant such as Prozac believed that they did not really work and that that they had lots of harmful side effects, then that belief itself, would cause a detriment to the individual - the nocebo effect."

There is no examiner in the history of IB Psychology who wouldn't stop and read those few sentences twice and think to themselves that this student not only knows her stuff, but is a top notch critical thinker too.

Author: Derek Burton – Passionate about IB Psychology

IB DipLOMA Psycho﻿logY:

The IB Psychology Blog. A place to share research and teaching and learning ideas for those studying and teaching Psychology for the IB Diploma Programme.